436 PRONE THORACOSCOPIC ESOPHAGECTOMY FOR PATIENTS WITH LOW PULMONARY FUNCTION

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Gosuke Takiguchi ◽  
Taro Oshikiri ◽  
Manabu Horikawa ◽  
Yu Kitamura ◽  
Kazumasa Horie ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Respiratory Function ◽  
Operation Time ◽  
Thoracoscopic Esophagectomy ◽  
Control Group ◽  
Respiratory Disorder ◽  
Short Term ◽  
Postoperative Respiratory Complications ◽  
Posterior Mediastinal ◽  
Posterior Mediastinal Route

Abstract   Thoracoscopic esophagectomy in the prone position (TEP) for esophageal cancer is reported to have superiority in preserving postoperative respiratory function and reducing postoperative respiratory complications. In Japan, the majority of patients with esophageal cancer are smokers and have obstructive ventilation disorders. But, the feasibirity and safety of TEP for patients with low respiratory function is unclear. Objectives To clarify the feasibirity and safety of TEP for esophageal cancer patients with obstructive respiratory function. Methods The 95 patients with obstructive respiratory disorder who underwent TEP and gastric tube reconstruction via posterior mediastinal route for esophageal cancer from January 2016 to April 2019 were divided into the two groups, low respiratory function (LRF) group and the control group. Short-term outcomes were compared between two groups. Results The control group was 73 cases, and the LRF group was 22 cases. Propensity score matching using age, gender, cT, and cN as covariates was used to identify matched patients (22 per group) in both groups. There were no differences in operation time of overall and intrathoracic part, or blood loss in each group. In the postoperative complications, pneumonia (13.6% vs. 9.1%), recurrent laryngeal palsy (18.2% vs. 22.7%), anastomotic leakage (13.6% vs. 13.6%) and hospital stay (36.3 days vs 27.5 days) were no differences in both groups. Conclusion TEP can be feasible and safe for the patients with obstructive ventilation disorder and low respiratory function.

scholarly journals Reconstruction after esophagectomy for esophageal cancer: Retrosternal or posterior mediastinal route?

2011 ◽  
Vol 74 (11) ◽  
pp. 505-510 ◽  
Author(s):  
Mei-Lin Chan ◽  
Chih-Cheng Hsieh ◽  
Cheng-Wien Wang ◽  
Min-Hsiung Huang ◽  
Wen-Hu Hsu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Posterior Mediastinal ◽  
Posterior Mediastinal Route

Esophageal cancer treatment in our institute from 1999 to 2005

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15183-15183
Author(s):  
Y. Miyazaki ◽  
H. Imamura ◽  
T. Kishimoto ◽  
K. Yamamoto ◽  
H. Furukawa
Keyword(s):  
Esophageal Cancer ◽  
Surgical Treatment ◽  
Survival Rate ◽  
Cell Carcinoma ◽  
Neoadjuvant Chemoradiotherapy ◽  
The United States ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Posterior Mediastinal ◽  
Posterior Mediastinal Route

15183 Background: 5 year survival rate of esophageal cancer in Japan reported to the Japanese Society for Esophageal Diseases from 1988 to 1994 (9,143 cases) was improved to 35.5% comparing to the rate of the beginning of 1980 which remained around 20%. This result was given by the increase of early cancer cases attributed to the progress of the ability of diagnosis, the improvement of the postoperative management, and the 3 field lymph node dissection introduced from the middle of 1980. Biological malignant potential and the modality of treatment for esophageal cancer in Japan differs from those in the United States. Methods: We studied clinicopathological characteristic and treatment results of 63 esophageal cancer patients in our institute from 1999 to 2005. Results: 63 patients consisted of 47 males and 16 females with mean age of 63.4±11.4. Out of 47 patients who underwent surgical treatment, 6 and 4 patients underwent neoadjuvant chemoradiotherapy and chemotherapy, respectively. 15 patients without surgical treatment consisted of 12 patients, including one patient after endoscopical mucosal resection, undergoing chemoradiotherapy, 2 patients undergoing chemotherapy, and 3 patients undergoing radiotherapy, respectively. Most common histological type was squamous cell carcinoma (55 patients), followed by adenocarcinoma (3 patients), small cell carcinoma(3 patients), others(2 patients), and unknown(1 patients). There was 1 surgical treatment-related death. The major complications were SSI (18 patients), anastomotic leakage(7 patients) and recurrent nerve palsy (5 patients). The 2-year survival rate of patients with surgical resection was 68.1%, while the rate of the unresectable patients was 38.9%.Since 2002, we have adopted posterior mediastinal route as a prime choice, rather than retrosternal route. The median amount of blood loss, rate of complications and duration of post operative hospital stay of each routes are 650/415(ml), 65/45(%), 35/22(day), respectively. These results suggested that posterior mediastinal route showed superiority comparing to restrosternal route. Conclusions: Backed by these outcomes, we will aim to establish a logical strategy for esophageal cancer therapy which could accompany fewer complications, respect quality of life and prolong survival time. No significant financial relationships to disclose.

scholarly journals Influence of different kinds of surgical resection on operation-related clinical indexes, inflammatory cytokines and complications in elderly patients with esophageal cancer

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Tao Zhang ◽  
Hai Jiang ◽  
Chen Yu Ming ◽  
Yan Wang ◽  
Deng Mao ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Elderly Patients ◽  
Lymph Nodes ◽  
Inflammatory Cytokines ◽  
Operation Time ◽  
Control Group ◽  
Observation Group ◽  
Incision Length ◽  
Sf 36

Objective: To investigate the effects of two kinds of surgical resection schemes, a conventional open surgical scheme and a thoracolaparoscopic esophagectomy surgical scheme, on operation-related clinical indexes, inflammatory cytokines and complications in elderly patients with esophageal cancer. Methods: A total of 100 elderly patients with esophageal cancer seen in the Department of Cardiothoracic Vascular Surgery, Renmin Hospital, Hubei University of Medicine, from June 2014 to June 2016 were enrolled and randomly divided into two groups, including a control group (50 patients) with a conventional open surgical scheme and an observation group (50 patients) with a thoracolaparoscopic esophagectomy surgical scheme. The operation time, the amount of bleeding during the operation, the incision length, the number of lymph nodes dissected, the hospitalization time, the HAMA scores and HAMD scores before and after the operation, the PSQI scores, SF-36 scores and levels of PCT, CRP and IL-6 after the operation, the recurrence and metastasis rates and the mortality at follow-up and the incidence of related complications of both groups were compared. Results: The operation time, the amount of bleeding during the operation, the incision length and the hospitalization time in the observation group were significantly less than those in the control group (p<0.05). The number of lymph nodes dissected in the observation group was significantly higher than that in the control group (p<0.05). The HAMA scores and HAMD scores after the operation in the observation group were significantly lower than those in the control group and those before the operation (p<0.05). The PSQI scores and SF-36 scores after the operation in the observation group were significantly better than those in the control group and those before the operation (p<0.05). The levels of PCT, CRP and IL-6 after the operation in the observation group were significantly lower than those in the control group (p<0.05). The recurrence and metastasis rates at follow-up in the observation group were significantly lower than those in the control group (p<0.05). There was no significant difference in mortality at follow-up between the two groups (p>0.05). The complication incidence after the operation in the observation group was significantly lower than that in the control group (p<0.05). Conclusion: Compared with a conventional open surgical scheme, the thoracolaparoscopic esophagectomy surgical scheme possesses advantages in the treatment of elderly patients with esophageal cancer, including being a minimally invasive, simple operation, having a shorter recovery time, effectively relieving negative emotions, improving the quality of life, reducing the levels of inflammatory molecules and reducing the risk of related complications. doi: https://doi.org/10.12669/pjms.36.3.1465 How to cite this:Mahjoubi F, Hashemipour M, Moshiri F, Iranpour R, Amini M, . Genetic analysis of TTF2 gene in congenital hypothyroid infants with thyroid dysgenesis. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.1465 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Minimally invasive esophagectomy with intrathoracic anastomosis in a situs inversus totalis patient

2020 ◽  
Author(s):  
Yunchong Meng ◽  
Zheng Zhang ◽  
Kuo Li ◽  
Quanfu Huang ◽  
Wenlin Qiu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Situs Inversus ◽  
Minimally Invasive Esophagectomy ◽  
Operation Time ◽  
Situs Inversus Totalis ◽  
Thoracoscopic Esophagectomy ◽  
Cancer Case ◽  
Intrathoracic Anastomosis ◽  
Invasive Esophagectomy ◽  
Estimated Blood Loss

Abstract Background Situs inversus totalis (SIT) is a rare congenital condition which is characterized by abnormal placement of the thoracic and abdominal organs. Laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis is technically difficult and has rarely been reported in SIT patients with esophageal cancer. Case presentation: We report a SIT patient whose condition is complicated by middle and lower esophageal cancer. This 55-year-old patient underwent total laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis. The overall operation time was 270 minutes. Estimated blood loss was 150 mL and the patient was discharged after 20 days. Conclusions Laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis is technically feasible and secure in SIT patients with esophageal cancer.

PS01.220: COMPARISON OF SHORT-TERM OUTCOMES BETWEEN RAMIE AND VAMIE IN TREATMENT MIDDLE THORACIC ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 112-112
Author(s):  
Yidan Lin ◽  
Hanyu Deng
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Lymph Nodes ◽  
Conflicts Of Interest ◽  
Minimally Invasive Esophagectomy ◽  
Operation Time ◽  
Short Term ◽  
Thoracic Esophageal Cancer ◽  
Comparable Rate ◽  
Invasive Esophagectomy

Abstract Background Whether robot-assisted minimally invasive esophagectomy (RAMIE) has any advantages over video-assisted minimally invasive esophagectomy (VAMIE) remains controversial. In this study, we tried to compare the short-term outcomes of RAMIE with that of VAMIE in treating middle thoracic esophageal cancer from a single medical center. Methods Consecutive patients undergoing RAMIE or VAMIE for middle thoracic esophageal cancer from April 2016 to April 2017 were prospectively included for analysis. Baseline data and pathological findings as well as short-term outcomes of these two group (RAMIE group and VAMIE group) patients were collected and compared. A total of 84 patients (RAMIE group: 42 patients, VAMIE group: 42 patients) were included for analysis. Results The baseline characteristics between the two groups were comparable. RAMIE yielded significantly larger numbers of total dissected lymph nodes (21.9 and 17.8, respectively; P = 0.042) and right recurrent laryngeal nerve (RLN) lymph nodes (2.1 and 1.2, respectively; P = 0.033) as well as abdominal lymph nodes (10.8 and 7.7, respectively; P = 0.041) than VAMIE. Even though RAMIE may consume more overall operation time, it could significant decrease total blood loss compared to VAMIE (97 and 161 ml, respectively; P = 0.015). Postoperatively, no difference of the risk of major complications or hospital stay was observed between the two groups. Conclusion RAMIE had significant advantage of lymphadenectomy especially for dissecting RLN lymph nodes over VAMIE with comparable rate of postoperative complications. Further randomized controlled trials are badly needed to confirm and update our conclusions. Disclosure All authors have declared no conflicts of interest.

Surgical Outcome of Colon Interposition by the Posterior Mediastinal Route for Thoracic Esophageal Cancer

2007 ◽  
Vol 83 (4) ◽  
pp. 1273-1278 ◽  
Author(s):  
Satoru Motoyama ◽  
Michihiko Kitamura ◽  
Reijiro Saito ◽  
Kiyotomi Maruyama ◽  
Yusuke Sato ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Surgical Outcome ◽  
Colon Interposition ◽  
Thoracic Esophageal Cancer ◽  
Posterior Mediastinal ◽  
Posterior Mediastinal Route

scholarly journals Chylothorax after esophagectomy treated with inguinal intranodal lymphangiography and transvenous retrograde thoracic duct embolization

2021 ◽  
Author(s):  
Yuta Sato ◽  
Yoshihiro Tanaka ◽  
Takeharu Imai ◽  
Hiroshi Kawada ◽  
Naoki Okumura ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Thoracic Duct ◽  
Gastric Tube ◽  
Treatment Options ◽  
Effective Treatment Option ◽  
Major Morbidity ◽  
Posterior Mediastinal ◽  
Posterior Mediastinal Route ◽  
Intranodal Lymphangiography ◽  
High Output

AbstractChylothorax after esophagectomy is a serious complication that is associated with major morbidity due to dehydration and malnutrition. Reoperation with ligation of the thoracic duct is considered for patients with high-output chyle leaks that have failed conservative management. In this report, we present the treatment options for chylothorax after esophagectomy: inguinal intranodal lymphangiography and transvenous retrograde thoracic duct embolization. A 74-year-old man with esophageal cancer had been operated with thoracoscopic esophagectomy. Six days after surgery, he presented with high-output chyle leaks. Conservative treatment did not result in a significant improvement. Inguinal intranodal lymphangiography and transvenous retrograde thoracic duct embolization were performed 13 days after surgery and were technically and clinically successful. Inguinal intranodal lymphangiography and transvenous retrograde thoracic duct embolization are an effective treatment option, especially for patients after esophagectomy with reconstruction performed via the posterior mediastinal route, without the potential for damage the gastric tube and omentum.

PS02.005: THORACOSCOPIC ESOPHAGECTOMY IN PRONE POSITION USING A PRECEDING ANTERIOR APPROACH FOR ESOPHAGEAL CANCER: LONG-TERM AND SHORT-TERM OUTCOMES

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 121-121
Author(s):  
Soji Ozawa ◽  
Junya Oguma ◽  
Akihito Kazuno ◽  
Miho Yamamoto ◽  
Yamato Nimomiya ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Nodes ◽  
Anterior Approach ◽  
Thoracoscopic Esophagectomy ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Thoracoscopic Procedure ◽  
Better Than

Abstract Background The purpose of this study was to clarify the long-term and short-term outcomes of consecutive patients who underwent thoracoscopic esophagectomy in prone position using a preceding anterior approach for the resection of esophageal cancer at a single institution. Methods We retrospectively reviewed a database of 690 patients with thoracic esophageal cancer who had undergone a thoracoscopic esophagectomy (TE, 351 patients) or an esophagectomy through thoracotomy (OE, 343 patients) between 2003 and 2017. To compare the long-term outcomes of TE and OE, we used a propensity score matching analysis and a Kaplan-Meier survival analysis. To analyze the short-term outcomes of TE, patients were chronologically divided into three groups (117 patients per group). As for thoracoscopic procedure, the esophagus was mobilized from the anterior structure during the first step and from the posterior structure during the second step. The lymph nodes around the esophagus were also dissected anteriorly and posteriorly. The intraoperative factors, the number of dissected lymph nodes, and the incidence of adverse events were compared among the three period groups. Results As for long term outcome, 203 patients from each group, for a total of 406 patients, were completely selected and paired. The 5-year survival of the TE patients (66.8%) was better than that of the OE patients (56.4%) (P = 0.044). The thoracoscopic times were 226 min, 241 min, and 214 min (P < 0.001), and the blood losses during the thoracoscopic procedure were 36.1 mL, 43.3 mL, and 18.0 mL (P < 0.001), respectively, according to the period groups. The mean numbers of harvested lymph nodes in the chest were 22.2, 25.1, and 28.9 (P < 0.001). The rates of recurrent laryngeal nerve palsy were 23.9%, 29.9%, and 8.6% (P < 0.001). Conclusion The long-term outcome of TE patients might be better than that of OE patients. As for the short-term outcomes, intraoperative factors, quality of lymph node dissection, and reduction of adverse events were best in the third period group. Establishment of standard procedure and accumulation of surgical cases seemed to make TE a safe and effective procedure for esophageal cancer. Disclosure All authors have declared no conflicts of interest.

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